Atypical Gianotti-Crosti syndrome in two HIV and hepatitis B co-infected adults.

We describe an atypical Gianotti-Crosti syndrome in two 43-year-old, unrelated adult male patients with coexistent hepatitis B and HIV infection. Both cases shared many of the hallmarks of childhood Gianotti-Crosti syndrome. We believe that this is the first report in the literature of a Gianotti-Crosti syndrome-like paraviral eruption in HIV and hepatitis B positive adults. The protracted duration of the exanthem, of between 4 and 25 months, may have been related to their underlying HIV infection. Immunoperoxidase studies suggest the presence of hepatitis B surface antigens within the vessels of both lesional and perilesional skin, providing further support for the proposed, immune-mediated pathogenesis of paraviral eruptions.